The Dr. Hyman Show - Do You Keep Getting Sick? How To Break The Cycle Of Illness

Episode Date: December 18, 2023

Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Get Ad-free Episodes & Dr. Hyman+ Audio Exclusives The foundation of our health is a robust immune system that has a very important mechanism of cleaning out inflammatory cells. If this process is broken, the inflammatory cells can actually turn other functioning cells into inflammatory cells. Our daily life habits and exposures, such as sleep, stress management, diet, and toxins, affect key biological processes that impact our immune function. When our immune health is functioning properly, the rest of our body follows with less illness and disease. In today’s episode, I talk with Dr. Elizabeth Boham and Dr. Leonard Calabrese about ways that we can support our immune systems to reduce the chance of illness and disease. Dr. Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. Dr. Leonard Calabrese is a Professor of Medicine at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University and Vice Chair of the Department of Rheumatic and Immunologic Diseases. He is also the director of the RJ Fasenmyer Center for Clinical Immunology at the Cleveland Clinic and holds joint appointments in the Department of Infectious Diseases and the Wellness Institute. This episode is brought to you by Rupa University, AG1, and Paleovalley. Rupa University is hosting FREE classes and bootcamps for healthcare providers who want to learn more about Functional Medicine testing. Sign up at RupaUniversity.com. Get your daily serving of vitamins, minerals, adaptogens, and more with AG1. Head to DrinkAG1.com/Hyman and get 10 FREE travel packs with your first order. Paleovalley is giving listeners an additional 15% off their first order. Just visit Paleovalley.com/Hyman to save on clean snacks and supplements. Full-length episodes of these interviews can be found here: Dr. Mark Hyman Dr. Elizabeth Boham Dr. Leonard Calabrese

Coming up on this week's episode of The Doctor's Pharmacy, we're kind of in a challenging moment for human immune systems. We are dealing with things we never had to deal with before. Hi, it's Dr. Mark. We live in such an exciting time. We're adding to our scientific knowledge of the human body almost every day. But as healthcare providers, it can be daunting to try to keep up with the latest information, especially when it comes to something as critical as lab testing. Well, I have a solution for you. Rupa University. Their mission is to provide affordable education by bringing in world-class experts to teach about lab testing. Every week, they host a free live

class where they bring in an industry expert to give an up-to-date overview of a lab topic or health concern. And if you want to dive deeper into a specific topic, you can attend a paid six-week bootcamp. So if you're a healthcare provider wanting to learn more about functional medicine testing, you owe it to yourself to check it out today. There are no prerequisites and everything is recorded and sent out to you afterward, which means you're getting a ton of value for your time. Just go to rupainiversity.com and sign up for a free live class or a bootcamp. That's rupainiversity, r-u-p-a-university.com. You know that my goal is to live to be 120 and thrive while doing it. Well, I'm always looking for tools and strategies to help me get there. I want to share with you one of the tools that I found and love, a nutritional supplement called AG1. AG1 supports your body's

universal needs like nutrient replenishment, gut optimization, stress management, and immune support. By giving your body nutrients it can easily absorb and utilize, AG1 supports your daily performance and elevates your baseline health. I drink AG1 every day and ever since I started I've consistently felt better and had more energy throughout the day. I just add a scoop into my water in the morning and I feel the effects all day long. If you want to take ownership of your health, it starts with AG1. Try AG1 and get 10 free AG1 travel packs with your first purchase. Go to drinkag1.com forward slash hymen. That's drinkag1.com forward slash hymen and check it out. And now let's get back to this week's episode of The Doctor's Pharmacy. Hi, this is Lauren Fee and one of of the producers of the Doctors Pharmacy podcast.

If you have been wondering why you or a loved one gets sick all the time, the experts in this compilation episode will guide you on how to rejuvenate your immune system. Our immune systems are under attack because of so many things we face in our modern world, like environmental toxins, fake food, and chronic stress. In today's episode, we feature three conversations from the doctor's pharmacy about why creating immune resilience is so important. Dr. Hyman speaks about how senescence of our cells hastens aging and poor immune response. Then he speaks with Dr. Elizabeth Boehm about a case study of a young boy who was always getting sick immune system. Let's jump in. How do we optimize our immune function? How do we

regulate it? How do we rejuvenate it? It's a whole new concept rather than immune boosting or immune suppression. How about immune rejuvenation? This is a beautiful way of thinking about how do we regulate our immune system to do what it's supposed to do and not do what it's not supposed to do, which is happening a lot in our culture because we have such an overactive immune system, given our inflammatory diet, given environmental toxins, given the change in our microbiome, given our levels of stress and so on, we all are experiencing immune system dysfunction at some level. So we also want to understand how inflammation plays a role in aging and how do we regulate the process of getting older without dealing with the consequences of chronic inflammation, which is driving so much

of the age-related diseases. I wrote about this a lot in my book, Young Forever. There's a whole concept of a chronic systemic sterile inflammation. It's not inflammation that's coming from getting an infection, but it's this low-grade chronic inflammation that we now refer to as inflammaging, the inflammation that occurs as we age. And that actually accelerates every aspect of aging. So how do we regulate that? How do we understand how to not neglect our immune systems

as we get older and make them strong and fit and be able to be resilient and rejuvenate their effect, which is basically diminished as we age. We're less likely to be able to fight infections and cancer. So our immune system is dysfunctional at that level. And at the same time, it actually is causing more inflammation that leads to more autoimmunity and chronic sterile inflammation that leads to heart disease, cancer, diabetes, and dementia. So we have to really understand the way to rethink our immune system to both upregulate our ability to fight cancer and infection, but also reduce the levels of inflammation and autoimmunity that happen as we get older. Now, immunorejuvenation is a relatively new concept. It was really sort of framed by my mentor, Jeffrey Bland, Dr. Jeffrey Bland, the father of functional medicine, who was a student of Linus Pauling, and has taken this concept of immuno-rejuvenation and actually created a whole

company around it called Big Bold Health. And just for full transparency, I'm an investor, I'm an advisor. I believe so much in the work that Jeff's doing. He's taught me most of what I know in medicine. So we have to think about this a little differently. So today we're going to talk about immuno-rejuvenation, what it is, how it happens in the body, and how to turn it on. How do we rejuvenate our immune system? Now, why is the concept of immunorejuvenation

better than our conventional approach to immune health? Well, immunorejuvenation essentially trains your immune system to work better at every level. Your immune systems turn over fast, your white cells turn over fast, you build a new immune system regularly, everything comes from your blood and bone marrow, right? So your hemipatic stem cells are generating new white cells and all the different types of cells. So you really need to kind of learn how to build the right immune system and not have it degrade as we age. Now, what happens as we age typically is not immunorejuvenation, but a concept called immunosenescence, which is the aging of our immune system. And that's damage that occurs in our body as a result of a dysfunctional immune system,

one that generates more inflammation that causes aging and less immune support that actually helps you fight infection and cancer. And what happens is we develop these cells called zombie cells. They're terrible cells. I wrote about them in my book. It's one of the hallmarks of aging. They're also known as senescent cells. And what they do is they tend to spread inflammation

like a wildfire throughout your body. And they make other cells, zombie cells, just like zombies make other people zombies. It's the same idea. And you end up with a lot of these senescent cells running around your body that are causing you to age faster. So how do we deal with them? How do we actually get rid of them? How do we deal with them how do we actually get rid of them how do we rejuvenate our body to get rid of the zombie cells to make room for healthy new cells well um we're kind of in in a challenging moment uh in history for human immune systems we are dealing with things we never had to deal with before uh and and the worst uh is our diet which is a highly inflammatory diet.

Our processed food diet, high sugar and starch diet, high refined oils, lack of enough phytochemicals and medicines in food, anti-inflammatory compounds in food, omega-3 fats in our diet. We are really having a horrible dietary experience in America and around the world globally. And we're seeing that effect on driving all the inflammatory diseases, especially obesity. And then there's not just our inflammatory diet, but all the environmental toxins that we have to deal with. And we're also having an increased spread of globalization of microbes, like we saw with COVID and the pandemic. It happens, you know, one in one country a thousand years ago wouldn't get anywhere because you couldn't get anywhere, but now it spreads like a wildfire. So we also have other things like stress, psychological stress, physical stresses, all create stress on the immune system. So this really sets the stage for this chronic

inflammatory state. It makes us more susceptible to infections, more susceptible to food sensitivities, allergies, and autoimmunity, as well as rapid aging. So the question is, how do we lose the science of immunology, the emerging science of understanding immunorejuvenation to help the body to reset, to help the body fight this process of inflammation as we age, to help deal with the zombie cells, and to basically make our immune systems more resilient. Well, the way basically we do cleaning up of our cells is through killing of the bad cells, or they die, and then we have to clean and recycle them up. And this is called autophagy. And this is something I've talked a lot this is called autophagy and this something

i've talked a lot about but autophagy is simply this process of self-cleaning like a self-cleaning oven where your your sort of body has this process to kind of gobble up like with pac-man little things called lysosomes gobble up all the old cells or damaged cells or damaged proteins digest them and break them down in the component parts and then reuse them like recycling. And it's quite an amazing process. And we often have a degraded process of autophagy as we age. And there's lots of things we can do to stimulate it. And a lot of the ways we can do it actually is through food and through the right nutrients in food and through the right phytochemicals in food. So we also have to actually understand how to also rejuvenate our mitochondria because our mitochondria are the energy factories of our cells or the place where we make ATP that drives all of our biological

processes. So when our mitochondria age, we age and we need to rejuvenate our mitochondria as well. So again, this is like mitophagy is similar to autophagy. It's a process of recycling, getting rid of the old mitochondria, building new ones. And you need a good immune system to do that because any kind of inflammation will cause mitochondrial dysfunction. So when you look at the body's ability to rejuvenate, it's quite remarkable. We have our own built-in process of rejuvenation. We have stem cells. We have immune cells that can help us rejuvenate. We can actually activate all these processes, but we have to learn how.

So the question is, what can we do to activate our own body's amino rejuvenation system? What are the research showing us about how do we cultivate a healthier immune system? Well, there's a few things. Food, right? So food is so important. And so eating an anti-inflammatory diet that's plant-rich, that's full of phytochemicals, that has medicinal properties in them that actually can kill some of the zombie cells, can rejuvenate your immune system, can reduce the inflammation, is so important. So lots of colorful fruits and vegetables. One of the things that I like are prebiotics and polyphenols. And they are in various kinds of foods. One of the most important foods for immunorejuvenation is something called

Himalayan tartary buckwheat. Now, this is an ancient grain, not even a grain, it's actually a flower. So it's not even a grain, even though it's called wheat, it's not wheat. So that's confusing. But anyway, it's grown in the Himalayas and it's got over 132 phytochemicals, many of which are not found anywhere else in nature, and have a powerful ability to regulate immunity. And some of them, like quercetin, we've seen reverse biological age. And some preliminary data, they've shown that using Himalayan tariff buckwheat, we can actually reverse our biological age by rejuvenating our immune system. So really important. Next is stay active. So moving your body, exercise, interval training,

really powerful for actually rejuvenating your immune system. Over-exercising actually can cause a problem, but the right amount of exercise actually helps build immunity. Also make sure you get the right omega-3 fats because essential fatty acids are so important. And most fish oils are not that great because they process the fish oil in a way that degrades some of the most anti-inflammatory components

we call pro-resolvent mediators, which are basically like brakes on the immune system. And they also take out a lot of the important things like astaxanthin, which is important for inflammation. It is an antioxidant that is found in a lot of the omega-3 fat containing fish like salmon. So, want to make sure you have the right omega-3s. Also, you want to fertilize your microbiome. So, both polyphenols from colorful plant foods, but prebiotic and probiotic foods

are really important. And there's a lot of them out there. We've talked a lot about it on the podcast, but we want to make sure you're increasing preinct, pre and probiotic foods. Also get rid of all the junk, right? The processed food, fried foods, sugary foods, junk foods. These are things that are just driving inflammation and actually worsening your immune system. Also sleep, really important. If you don't sleep, your immune system is not going to work well. So seven, eight hours of good sleep, really important. Now, the other thing is that there are positive things that are going to help you improve your immune system, like stressors, for example. We know that a stress isn't always bad, that there are good stresses that activate your body's own healing response. So basically, this kind of stress is called hormesis. And hormesis is the idea that there's

a stress that doesn't kill you that makes you stronger. So essentially, it takes some kind of insult, which could be exercise or fasting or a sauna or a cold plunge, and it tricks your body into thinking something bad's happening. And then your body responds by creating a defensive response by activating all its healing and rejuvenation repair systems. So it's really important. And I think there's a lot of ways to do this. So, and these positive stresses are important. They help you become more resilient. So the goal is to become more resilient, more stress resilient, more immune resilient, be able to adapt to a lot of changes and actually deal

with what has to happen. Now, one of the ways we can actually stimulate the process of healing in the body is through sort of plant compounds that they have used and developed to protect themselves. These are the plant's own protective defensive mechanisms, and they're called phytochemicals. And when the plants are stressed, they make more of these. They're their own defense system. They're their immune system. So it's great to eat these things because they actually activate your body's own healing system. So when plants have to deal with bad soil or temperature extremes or insects that are trying to fight off or floods or droughts, they create all these incredible molecules

that are part of their own defense systems. And when we actually eat these, it's like part of their own defense systems. And when we actually eat these, it's like eating a little bit of adversity, and then they activate our body's own healing systems. And it's really powerful. Now, Dr. Bland has come up with an approach to immune health that I think is quite brilliant because it deals with three key categories of foods and components in our food that can really rejuvenate our immune system. The first are polyphenols from plants, things like quercetin, luteolin, and asperidin, all these bioflavonoids that are found in food that can really rejuvenate our immune system. And they're

found in abundance in this Himalayan tangerine buckwheat. The second is eating the right amounts of omega fats, omega-3 fats fats and the right kind. And again, I know I'm an investor in Big Bold Health, but they've come up with a model of getting fish oil and extracting the omega-3s from it and keeping the pro-resolving mediators, preventing the degradation. It's purified. There's no toxins in it, it's cold processed, so it retains all its benefit, and it's quite a different omega-3 fat. The next is your microbiome, and this is supporting your microbiome through pre- and probiotic foods. And actually, Himalayan tartary buckwheat has these amazing microbiome-supporting fibers that are quite amazing. And basically, you want to make sure you get these from all sorts of foods, not just,

obviously, Himalayan tartary buckwheat, but omega-3 fats from fish polyphenols from plants fibers and pre and probiotics from from our food and they basically help us to build our own immune system so what are the kinds of other positive stressors other than food that we can use to upgrade our immune systems and immuno rejuvenate ourselves well first is uh hormesis so hormesis is is like i said this idea that what doesn't kill you makes you stronger and some of them are pretty simple to do for example temperature extremes hot and cold so you can do a sauna for 30 minutes at 170 degrees a regular sauna for 30 minutes, and you can go in and out, hot and cold, hot and cold. Doing that four times a week has enormous benefits for your health and longevity.

Cold plunge, if you get one, great. You can just fill up your bathtub with cold water or get a big horse trough and fill it with ice and water and go in that. You can even just take a cold shower. That also helps rejuvenate your immune system. Not overeating and actually having a diet that is time-restricted can be very important. So don't eat three hours before bed. Give yourself at least 16 hours, maybe 12, 14 if you're thin and you can't tolerate a longer period. But most people can deal with a 16-hour overnight fast. That's eating dinner at six and having breakfast at 10 in the morning. So it's not terrible. And it's powerful to actually drive

the activation of autophagy, mitophagy, and killing some of these zombie cells, rejuvenating your immune system. Do stuff that also challenges you in other ways, whether it's learning a new sport, whether it's bike riding or tennis or horseback riding. Do something that kind of puts you out of your comfort zone and makes you learn new stuff. I picked up tennis when I was 45, and I'm still learning. I'm still improving and growing, so it's amazing. And also, try something crazy like public speaking. I do it.

It's pretty easy for me, but if you're not used to it, it creates a stress in your system. It may actually be a good stress. So try lots of fun stuff. Try, do some fun and challenge yourself a little bit, both in terms of the life activities you can do, in terms of optimizing your diet, in terms of making sure you get all the right nutrients from polyphenols and from phytochemicals that are great for your gut microbiome, prebiotic fibers, and omega-3 fats. So that's a great way to really think about reshaping your immune system to actually deal with the ravages of aging and inflammation, but also to boost it so you can actually fight infections and cancer.

Hey, everyone. It's Dr. Hyman here. Now, so many of my patients ask me how I manage to work multiple jobs, travel frequently, and spend time with my family and still focus on my health. I know it can seem hard to eat well when you got a lot going on, but the trick is to never let yourself get into a food emergency and to stay stocked up with the right things to support your goals. So recently I discovered Paleo Valley Beef Sticks. I keep these beef sticks at home and at the office so I know that whenever I'm in a food emergency,

I have a healthy and delicious option to keep me on track. It's no secret that I have high standards when it comes to what I put in my body and Paleo Valley Beef Sticks checks all the boxes. They're gluten-free, grain-free, dairy-free, soy-free, and non-GMO. Plus, they use 100% grass-fed and grass-finished beef, which not only adds to the flavorful taste, but it also means they're free of any harmful antibiotics or hormones that you'll find in most meat.

With grass-fed beef, you'll get more nutrients than you would with beef fed with grains. Things like higher levels of omega-3 fats that help reduce inflammation, and more B vitamins and other antioxidants to support your body's converting food into energy, and also more of the fat-soluble vitamins that are beneficial for a healthy heart. Plus, instead of being processed with chemicals and other questionable ingredients, these beef sticks are naturally fermented so you get gut-friendly probiotics with every bite. How cool is that? Right now, Paleo Valley is offering my listeners 15% off your entire first order. Just go to paleovalley.com

forward slash hymen to check out all their clean paleo products and take advantage of this deal. That's paleovalley.com forward slash hyman. I definitely recommend stocking up on the grass-fed beef sticks to keep in your house, in your car, and in your office. It's one of my favorite tricks to staying healthy while on the go. All right, now let's get back to this week's episode of The Doctor's Pharmacy. Tell us, Liz, about some of your patients that you've discovered how to actually work with. Because this is something I also have seen in my practice. People get sick over and over again.

And you're just going to see these people like, why are you always getting sick? And then you start digging. And what are the kinds of things you find? What are out of balance? What's out of balance? So for the first person I wanted to talk about, he was a 10-year-old boy, and he was coming in because he was getting every cold and flu that was going around, right? So his mom was getting frustrated because he was out of school almost a couple weeks

a year, if not more, because he kept getting sick. And she, of course, had to take off work, and it was causing some disruption in their house. But she was also really just worried about him. Why was he picking up every cold and flu going around? We, you know, I got a good detailed history from him and he had multiple ear infections as a younger child. So when he was, you know, his first few years of life, even up to five, he was getting lots of ear infections and often treated with antibiotics, right?

So he would get an ear infection and he would take antibiotics and then he would get another ear infection and he would take more antibiotics. He had a lot of congestion in his nose and nasal passages. I mean, even when he wasn't sick. Even when he wasn't sick, he was dealing with it. And that's an issue we know because when there's a lot of congestion floating around, sometimes it gets stuck, right? So kids that have a lot of congestion in their nasal passageways and their eustachian tubes, more likely for it to get- They have more inflammation and it's more likely to get stuck and then another infection grows and

you get an ear infection, for example. So he had these recurrent chronic ear infections. So this is just to break it down a little bit. So what you're saying essentially is that if you're living a lifestyle or you have food sensitivities or something that's causing congestion and inflammation in your sinuses and your nose and your throat, that that sets the stage for recurring infections. Yeah. Right? So maybe the treatment isn't to fix the infection. It's to figure out why there's this problem.

Right. Because the congestion gets stuck. And then there's a breeding ground for a virus or bacteria to overgrow and an infection to take hold and for it not to be able to get out of the system, you know? And for him, you know, for him, he had these chronic ear infections, but now is getting everything. So when he had the chronic ear infections, it's important to note that he was given lots of antibiotics. So for his first five years of life, he was on multiple rounds of antibiotics, two, three times a year getting antibiotics for these

ear infections. And that is something we often see, right? We'll see that somebody gets an infection, right? For this kid, it was his ear infection, or for somebody else, it might be a urinary tract infection or sinus infection they are given antibiotics but those antibiotics get rid of the infection but they also they also can get rid of all that good bacteria that's lining the sinus passageways the digestive system the bladder area right so microbiome right so and and we know that those good bacteria they're like the first line of defense. They're like that army on the front line, right?

They can say, okay, virus, don't get into my body. Okay, another bacteria, don't come into my nose, right? Those good bacteria are lining all the passageways in our body. They're part of our defense system. Huge part of our immune system. Huge part of that innate immune system that immune system that's gonna that's gonna attack right away when something new or different comes into the body and so when we've been on a lot of antibiotics in the past we will often see people's who whose immune system is not working as well as we'd like

it to so um and i think what you're saying is that antibiotics, even though they treat infections, seem to mess up your immune system. I think they do. Yeah, absolutely. And I think there's good studies to show that. Sometimes an antibiotic is necessary, but there's definitely been multiple times with lots and lots of people,

and of course all the antibiotics in our food supply, they're damaging a lot of that good, protective, good bacteria that are our first line of our immune system. So absolutely. And then make you even more susceptible on the next round. Exactly. And that's, I think, one reason why we see these chronic infections with people, because they take the antibiotics, but then it gets rid of a lot of the good bacteria. So it's easier then next time for that virus or bacteria to take hold and to become an infection again. And so we see this sort of cyclical thing going on with people. And so I think that's important for us to pay attention to and say,

okay, let's step back and say, do we absolutely need to use this antibiotic this time for this situation? And I think as physicians, it's important that we're being more careful with the use of antibiotics. And but I think that's an area that we see issue with. And I think one reason for him, one of the reasons why he was more susceptible to these colds and flus. But I don't think it was the only reason. Yeah, what was the other thing you found?

That's important to note, right? We always want to find one thing. We always want to say, oh, it's the one reason why somebody's immune system isn't working as well. But many times it's multiple things coming together. And I just want to stop you for a minute there because in traditional medicine, we were trained to think about the one thing.

Yeah. We call it Occam's razor. What's the simplest explanation that could explain all of it? And we sort of do that a little bit in functional medicine, but the problem with traditional medicine is very reductionist. It's like this is one thing, and the truth is the body is complex,

it is a system, and it's many things. It's more like a web than a razor. Right? Yes, absolutely. And many times there's 10 different things going on that are contributing to why this person's immune system wasn't working well. So their microbiome, their diet, nutritional deficiencies, all sorts of things. So for this child, you know, we realized also because of all of this congestion and frequent

infections and a lot of ear infections as a kid, I said, well, you know what? Maybe we need to think about some food sensitivities that may be causing a lot of congestion for this kid and putting him at increased risk for these ear infections as a kid and infections now. Because we do know, we do know that dairy and cow's milk is associated with increased risk of ear infections for some kids. And also mucus production, congestion. I mean, I know if I eat dairy, I might immediately get running nose and congestion. It doesn't affect everybody by that way, but it does affect a lot of people that way. Yep. And he was willing. He was willing to say, okay, I'm going to... He was ready to say, I want to stop getting sick all the time. And so he was willing to go off of, you know, to do an elimination of dairy from his diet. And so that is one of the things we really focused on

and we worked on. And it really did help. His congestion decreased. He wasn't getting as sick as much. But we did more than that because we also realized that he, you know, I did some nutritional biomarkers. I realized he was a little low in zinc, which is, you know, not uncommon to find, you know? Zinc is so important for your immune function. In fact, in COVID-19, they're finding they're actually treating patients with zinc because it helps to interrupt the viral replication and the viral binding to the sort of cells and the insertion into the host DNA. So I think it's really interesting to see that even in this crazy, horrible infection

of COVID-19, we're going back to basic principles of what's required to help the immune system, zinc and vitamin C, which are being used intravenously in studies. Yes. And so for him, you know, we added in like 20 milligrams of zinc and 500 milligrams of vitamin C a day. And that was very helpful too, to help him break this cycle. In addition, we found out, we found out that he had some elevated levels of heavy metals. So, um, his lead was, was, his lead was a little bit high. He was living in a home. He'd grown up in a home that was like, um, it was built in the early like 1920s or so. So it had more just lead in the water and in the, in the walls of the house.

So it had been, it had been refurbished, but it's still, you know, his lead levels were higher than we'd like them to be. And we know, right, what we know about heavy metals, we know that high levels of lead are really a problem for both the neurological system and the immune system. But I think we also know that, you know, low levels can result in people's immune systems not working optimally. Yeah. And also, mercury and lead also affect the gut. So they interrupt the gut function, can cause leaky gut, growth of bad bugs in there. So you've got other reasons for this. Yes. Right. That's true. That's very true. So we also, not only did we pull away dairy from his

diet, we put him on a really good probiotic because he had been on so many antibiotics in the past. And probiotics, there's really, really interesting studies on how well they help the immune system. I mean, we need to do a lot more research here and figure this out a lot more, but they can really help with breaking some of the cycles for people who are chronically getting sick. I mean, I remember this study I read years ago. It was a pregnant woman who took probiotics compared to another group that didn't. And the women who took the probiotics during pregnancy, their offspring had dramatically less eczema and asthma and allergies because the mothers took it.

So same thing when you give it to kids, it also helps dramatically with these problems. Yeah, absolutely. And it can help improve the functioning of the immune system for some kids some kids in certain situations. And then of course we gave him that zinc and vitamin C, but then I gave him, I put him on a detoxification protocol. I really helped with getting these heavy metal levels down. We, we did a protocol that, that had multiple different components in it. But that was because we tested and we found that his heavy metals were a little bit high. So we worked to really bring them down with, you know, glutathione, liposomal vitamin C, some binding agents, things that helped support the detoxification system in his body. And, you know, that comprehensive approach really helped his immune system improve. And it helped

him get out of that cycle of getting sick two to three times every winter. And I think it's really fun to watch and see that because we can see that difference all the time. Yeah. I hear that so many times. I'll talk to Dr. Hyman. I don't get sick anymore. My sinuses, I don't get...

This is the first year I've gone without having antibiotics for my sinuses. I know, right? It's so simple. I remember this kid who just reminded me of this story when I was in the emergency room years ago. And I was working at Mercy Hospital in Springfield, Mass. And this woman came in with her toddler, who was probably like maybe about two years old. And had just so many ear infections, one after the other, after the other.

And I said, well, when did this all start? And she's like, well, it was about a year old. I said, what happened when he was a year old? She a year old. I switched him from breast milk to regular milk. And, and I was like, and this is before I knew about functional medicine or anything. I was like, oh, well, that's interesting. Why don't you take them off dairy and see what happens? And the kid was fine. So I think we, sometimes it's sort of that simple, but I think often it's more comprehensive because you, you, one, you change his diet, you optimize his nutrient levels, and you also in a little deeper to look at his detoxification and his

mental burden, which is also a factor. So you did diagnostic tests that can help pinpoint these issues and you can really create a precision approach to each individual. So this is his problem, but there may be somebody else who might have a different reason for their immune system not working. And I think it's really important to understand that we at the Ultra Wellness Center and in functional medicine take a very different lens at looking at these chronic problems and say, what is the cause? How do we get rid of the cause? And why isn't the body working properly? And when I learned functional medicine, one of my mentors was a guy named Sidney Baker,

who was sort of a Yale pediatrician, just brilliant guy. And he was incredibly good at taking incredibly complex ideas and simplifying them into a few principles. And one of the most important principles that guides me every day, still today, is a very simple question. It's what do you need to get rid of in your body that's making it unhappy and what does your body need to get in order to get healthy yes so what are the things that are the problems that cause disease and what are the missing factors that you need to have a resilient system and so this is for the immune system so this kid it was he had too much dairy that was bugging him. He had too many metals that were bugging him.

So you got rid of those things. And then you added in the things the body needed to function. You added in the probiotics. And you added in the zinc and the vitamin C. And the body knows what to do. It's like when you take out the bad stuff, you put in the good stuff. It's just that simple. And sometimes it's a tough job to figure out what the bad stuff is that you need to get rid of and what the good stuff is you need to get.

And that's where the real meat of functional medicine is, is being able to investigate those things properly. And we don't learn that in medical school. So functional medicine, we learn how to dive deep into being an expert in what are the things that cause disease and how do you create a healthy human. And I think that's really the power of supplements. You know, sometimes people are like, oh, you know, what does supplements matter? A multi, is this helpful? Expensive urine. Yeah. But, but when, when you, when you can identify what deficiencies people

have or what, because of their genetics, they need more of, right? When you can really specialize and, and give a personalized program for somebody, it makes a world of difference. You know, I remember, I remember in, in my undergraduate degree in nutrition and they were just like, oh, you know, don't bother with supplements. You know, it was really, it was really food first kind of a program. So I never took supplements. I remember the first time I took a multivitamin, I was like, whoa, this is amazing. And it was a good quality one with good methylated B vitamins. I had so much more energy because I needed that extra methylation because of my genetics, right? But like, so when you specialize and give a personalized approach, it really makes a huge

difference for people. So key, so key. So we see recurrent ear infections, recurrent sore throats, recurrent colds and flu. We also recurrent sinus issues, which are very similar. But you had a case of a woman with chronic bladder infections. Oh, this is so common. I mean, this is something we see all the time. And we know that at least 50% of women get one urinary tract infection in their lifetime, but lots and lots of women get many, many more, right? And a percentage of women have recurrent bladder infections to the point where they're put on antibiotics for prevention, right? They might be taking an antibiotic every time they have intercourse. I remember that. I learned about that in medical school. I'm like,

wow, that's such a bad idea. Right, because let's go back to the microbiome, right? We've got, we've got, we've got microbiome. We've got all that good bacteria that lines our urethra and our bladder. And so that when we take antibiotics all the time, that is killing off some of those good bacteria, just allowing that bad bacteria to get back in there again. Right. So, so it's really, we've got to work to break the cycle with women all the, you know, all the time with the chronic urinary tract infections. It's something I see, I see so often in my practice. And part of the women, reason women get it because of anatomy, they have a very short distance between their outlet, right. Of their bladder and the vagina. And then their bladder, it's very short, whereas

men, it's a lot longer, it's harder for the bacteria to migrate up there, and then it gets easily affected by, you know, hygiene and sex and dehydration. Yeah, I mean, there's, you know, the most common cause of a urinary tract infection is the E. coli bacteria, which, you know, comes from our gut, and so there's, like you said, there's not a lot of distance between where the stool is coming out and the urethra and the, and the bladder. So it's, it's not an un, you know, it's a common thing that we see, but there's a lot we can do to prevent that bacteria from, from taking hold. So this woman, she was a 40 year old woman who had had bladder infections, you know, her, her whole adult life and was on

at the point where she was needing to take an antibiotic every time she had intercourse. And, um, and, and really that was impacting so many other things. Now she was getting yeast infections and she was, you know, and, and, you know, her digestion was getting off. And so she, we were like, okay, we've got to get to this underlying, we have to work to break this cycle of chronic infections. And, you know, there's a lot of cool things that really help with stopping that cycle of recurrent bladder infections. I mean, you talked about some of the basics, right? Making sure you're drinking a lot of water, you know, urinating frequently. Peeing after sex. Peeing before and after sex, right? Yeah, wiping from front to back, wearing cotton.

I mean, all the basics. But then there's some stuff that really is helpful to help break the cycle. And one of those things are the probiotics. There's been a lot of really interesting research showing that there's certain forms of probiotics, the lactobacillus rhamnosus and the lactobacillus ruderi, which are good bacteria for the urinary tract system. Yeah. Right?

Like those bacteria you want to have a lot of in the urinary tract system. And that when there's good levels of those bacteria, things are going to work better there. You might not be as high risk of getting some of those recurrent infections. See, I was always trained that your whole urinary tract system is sterile, but you're saying there is a microbiome in the urinary tract. Absolutely, absolutely. And so you can take these probiotics,

you can take them by mouth. We often will have compounding pharmacies mix them and you can apply them vaginally too, make it easier for the- Yeah, it's great for yeast infections and recurrent issues. Yep, and help those good bacteria climb up the urethra and into the bladder. And, and, and so, but, but taking them by mouth is also helpful

to create that nice microbiome or help replete the nice microbiome in the bladder area. We know that that cranberry, you know, we've heard forever that cranberry is really helpful because it has a substance that prevents the bacteria from sticking to the bladder lining. So cranberry is really great. I often don't want to have people drink too much cranberry juice because it's high in sugar, but you can get powders of cranberry and there's capsules of cranberry that can be used. And D-mannose is another substance. but you can get unsweetened cranberry juice yes right yeah unsweetened cranberry concentrate that stuff is sour but it really works you can take a quarter cup of that yep you mix a little water and then drink it there's no sugar and it really works and

people can do it every half hour every hour two hours depending on the you know and really help break the cycle if they don't want to take antibiotics. I've had a lot of women who are just trying to break the cycle and we give them things like cranberry concentrate or cranberry supplements. And there's another one you were just mentioning, D-mannose. Yeah. I was going to mention also that other place to put the unsweetened cranberry concentrate is in like seltzer water. It's yummy that way.

Yeah, that's good. But the D-mannose is also another substance that prevents the binding of the bacteria to the bladder lining, so it's less likely to stick. And they've done studies showing that two grams of D-mannose can be as effective as antibiotics for prevention of a urinary tract infection. So both cranberry and D-mannose can be used for prevention. And then if somebody's starting to have symptoms, they can really increase the amount that they're using to sort of stop that infection from coming on.

So I think those can be really helpful as can the probiotics. And we use herbs too sometimes. You know, we try to avoid people getting antibiotics. Yeah. Yeah. I mean, a couple of things you want to watch for, right? If you get a fever, if you see any blood in your urine, if you get any back pain, if it's not getting better, you know, or, you know, if you get any back pain, if it's not getting better,

or you really work with your doctor on this because these infections can become serious for some people. And they engulf your kidneys, which is bad. Yeah, in certain situations. But some of those things can be really helpful for breaking the cycle. And I think that's important. When I worked with her, with this one patient, We added in some cranberry and D-mannose. She was taking it on a regular basis, but then she also took it after intercourse.

She took it frequently when she was starting to feel some sensation, like an infection might be coming on. We worked to make sure she was drinking lots and lots of water so her urine was more dilute. You changed her diet, too, right? I did, yeah. We got rid of... I mean, she was on a little too much sugar and sugar bad because it can it can feed the wrong bugs in the in the body right it can feed the yeast it can feed bad bacteria and and that is you know and also viruses too absolutely right because we know that when blood sugar is

too high that the immune system doesn't work as well, right? So for all those reasons, we cleaned up her diet, we pulled in a lot more of the good, healthy vegetables that are rich in phytonutrients, that are anti-inflammatory and can help support the immune system. And we helped her get off of the chronic antibiotics she was using because that is one of the best ways to help break the cycle of getting more and more infections. Yeah. So powerful. So just to recap, you know, we've had a couple of cases, one of recurrent ear infections

and colds and sore throats and flus and other bladder infections. But this really applies to anybody whose immune system is not working, who tends to get sick more often, who gets sinus issues. The treatments are sometimes slightly different, but we look differently at this with the lens of functional medicine. We look at diet, we look at food sensitivities, we look at the gut where 60% of your immune system is. We look at your nutritional levels like vitamin D. I mean, if your vitamin D level is low, you're much more likely to get the flu. And if your vitamin D levels are optimal, you can reduce the flu by 40 to 70%. Just that alone. And we look at zinc levels and levels of your overall nutritional status.

Vitamin A, right? Vitamin A, yeah. And so we really take a deep, comprehensive look. And is there something else that's destabilizing your immune system? Are there toxins, like in this little boy, that might be just destabilizing the immune system. So we really create a model of a real clear diagnosis through history, a dietary analysis, detailed testing if needed. It's a little bit different than when you get a traditional doctor. It looks at these sort of root causes. And then we kind of apply the method of restoring health. So we remove the bad stuff, like you remove the yeast and you remove the bad foods and inflammation, dietary factors,

maybe dairy, whatever it is. And then you add in all the things that need to rejuvenate the immune system, right? And it's some of the things we didn't talk about, like sleep and moderate exercise and stress reduction and the whole foods diet and getting off of processed foods and sugar. These are so simple and they're so profoundly effective in terms of rejuvenating immune system. It's well accepted that stress is bad for your immune system. I mean, classic chronic stress, you know, acute stress,

run from the saber-toothed tiger, that's really good. Chronic stress of my job, my life, the environment, politics, and the world is bad. We are now starting to appreciate that the opposite of that, the immunology of joy can be immunologically potentiating. And you mentioned a very nice example. I call this the immunology of gratitude. And gratitude has wide-ranging biologic effects. There's a recent study done at UC San Diego that showed that patients with asymptomatic, echocardiographically documented congestive heart failure with six weeks of gratitude journaling could improve ventricular function.

Your heart pumps better and faster if you're grateful. Right. So you've got to open your heart, essentially. It's exactly. Let's take this a couple of steps further. By the way, before you go on, there's another condition, which is the opposite, which is stress-induced heart failure. Broken heart.

Broken heart. I literally had a patient with a broken heart. He was healthy otherwise, and he went into heart failure after his wife died. Sure. And through using various modalities around stress and energy medicine, we were able to get it better. We think that that's the basis of voodoo deaths. Yeah. You're petrified in your heart.

So it's all connected. Bad fugu toxin. Right, right, right. So the immunology of joy, there's been some tremendous work in this. And it's such a great phase, the immunology of joy. Yeah. So some people, Cohen from Carnegie Mellon has done such beautiful work looking at resistance to respiratory viruses and the effects of hugs and did this elegantly controlled study where they measured social interactions, the amount of touching that goes on in a person's life, and then actually inoculated all the people in the study with a cold virus

and then measured their antibody responses and clinical things. And hugging was an important and significantly clinical variable. Even though the hug people were more exposed to viruses, you know, they were protected. So, I mean, a small example. That's great. So, hugs so you won't get sick. That's why when Lenny ever comes to see me, we always hug each other. Absolutely. It's great. So hugs, so you won't get sick. That's why when Lenny ever comes to see me, we always hug each other. It's therapeutic, right? He's the only doctor at Cleveland Clinic who gives me a hug. It's pretty amazing. That's good. I want to be known for that.

Fulvio De Quista from London, who's going to be visiting us in May, where my immunology summit, which has been going on for 16 years, is actually going to start out full half day on the immunology of wellness, who does experimental work on the immunology of joy. And he actually has animal models, mice, take mice and let them live in his little home, take another set of mice and put them in a dirty cage and they get all upset. And you take the other set of mice and you them live in his little home. Take another set of mice and put them in a dirty cage and they get all upset. And you take the other set of mice and you put them in the Ritz-Carlton house and you pet them, their immune systems shift. So we don't know how to quantify this, but it certainly fits with our model that in those

behaviors of diet, exercise, sleep, and stress, we want to move our affect in a more positive manner. And I see this every single day that, you know, sometimes we see immunologic diseases that we just can't do anything about with targeted therapy. And we have to deal with it, you know, bio-behaviorally. And people have to, they have to be empowered to do this. And that's where I think that, you know, you guys have been doing this for your whole career. And, you know, but 20 years ago, you were the wellness guys. You were over here. All right. You're over here. This is alternative therapy. I'm trying to bring immunologic strength, wellness,

and immunologic health building to the mainstream of people, some of the people that you're interviewing on the show, who deal with immune-mediated inflammatory diseases every single day. So we're shifting the curve a little bit. Well, what you said was really important before. You said before wellness was sort of a nice idea that we all believed in, but didn't have a lot of data. Now you're saying there's a lot more data. And I saw a study recently where they literally injected cold viruses into people's nose and they looked at stress questionnaires.

That's the same work of Sheldon Cohen. Incredible. And they found that those who scored high on the stress questionnaires got colds and the other ones didn't, even when they injected the cold virus right in their nose. That's right. So what kind of data are you seeing around stress and wellness, diet? Let's just kind of go through it. I want to spend a little time digging in because it's such a compelling area.

And I think your work is so important and you're such a great voice for this. Well, you know, we'll knock these down one at a time. But, you know, one of the interesting things that has happened here is that, you know, a decade ago, I felt very comfortable talking about this, these topics to the wellness community and, you know, translating it for them. But it's taken a bit longer, and only in the past five years am I now trying to take to the airways, literally, and in the scientific literature to bring it to my immunology colleagues. So it's a shift. And the data speak for itself. Let's just take one disease.

Let's take rheumatoid arthritis. So, okay, so for the audience, rheumatoid arthritis, um, uh, most common cause of inflammatory arthritis, um, you know, a hundred years ago, inexorable, terrible illness. Uh, the great Sir William Osler, the greatest physician of the, uh, of the past century said when he saw a patient with that disease walk in the front door, he would walk out the back door yeah even when i was a resident and fellow we had very little to offer steroids and and steroids were just in the dawn of them um today we know so much more about this so we have uh large studies the who gets rheumatoid Well, there's a genetic predisposition. You have the genetic makeup, but not everybody that carries the gene gets the disease.

So they have to... Not everybody who has the disease has the gene. Exactly. But most do. So we have hypothesized for a long time that there are environmental influences. So gene plus environment. And that environment may be external, could be your own behaviors. Big studies like the Women's Health Study that have looked at, you know, 100,000 women

for decades have found that if you take people, women who are predisposed to rheumatoid, it's a many autoimmune diseases are female predominant. More, yeah, most. Yes. And you look at certain variables, diet. Okay. And if you, you know, just to make this understandable, if we take the dietary range here from over here, the standard American diet, the sad diet. Yes. And over here, let's just call it the prudent diet. And at the end, we would peg this as a vegan diet. The further you go down toward a healthy diet, the more plant-based you become. Statistically, for each quartile, for each quarter of dietary health, you statistically lower the likelihood of developing rheumatoid arthritis, particularly when you're young and active. It's an unbelievable and stepwise regression. And so we know that diet can be a

tremendous influencer. Once you have the disease, once you have the disease, looking at dietary composition, we know that patients that eat fish twice a week will have statistically, and I'm not talking about trivial improvements, palpable lower disease activity than people who are non-fish eaters. And in fact, just eating any fish in your diet in these cross-sectional studies have suggested that it contributes to the composition, healthy fats, things that we can dig into a little bit later. So this is hugely important. So we can take people who are genetically predestined to this and modify their risks early on.

And once they have the disease, actually can make contributions to lowering disease activity. So what are the kind of diets, besides, for example, adding fish, what would be the dietary recommendations you'd give to someone with an inflammatory disease or rheumatoid arthritis? You know, so my recommendations are to, well, ultimately, you know, I'm very happy with someone who has achieved a semblance of what we would recognize as the Mediterranean diet. I'm very happy with people who have achieved becoming either total vegans or close to that. Very good data coming out now that paleo diet also can have some anti-inflammatory effects.

And pegan diet, I tell people. coming out now that paleo diet also can have some anti-inflammatory effects and pegan diet. You know, I tell people, you know, so, you know, people are not coming to me. So what's different for people who come to see you and people come to see me. So people are coming to see me are coming to have their disease sorted out. They're looking for the most advanced targeted therapies and they're looking for a little extra people coming look to you are looking how to rearrange their lives and do this so i have a very slow and stepwise yeah process might scare him away if he told me you know if you can do meatless monday i'm very happy let's start and then and the one thing that we know in imid diseases it it's not a foot race, it's a marathon. So I'm going to be seeing people for years and decades.

IMID diseases is immune-mediated inflammatory disease. So rheumatoid, inflammatory bowel disease. So we try to take the low-hanging fruit and try to make little modifications. And then over time, I'm so impressed that people can make meaningful progress. So that in the dietary aspect, I encourage real food, get rid of the junk, plant-based, monosaturates. I have no problem with protein as long as it's high quality. Yeah. And I think there's a place for it.

So that's where we start with people. Yeah. Step two, exercise. I became interested- By the way, for people maybe not realize, but 60% of your immune system is right underneath the lining of your gut. So it's there because you're exposed to foreign molecules from food and bugs and your immune

system is the first line of defense. And so when that system gets disrupted and you get what we call a leaky gut, it creates a lot of inflammation. And so changing your diet has a huge impact on there. Working on your inner garden, your gut microbiome plays a big role. Yeah, you know, I'm glad you brought that up. And diving into the science just a little bit, the microbiome, which is connected to every organ system in our body, and you've talked about it extensively on this show, is critical in both the development and the function of our immune system. I mean, you know, if you're born with a sterile gut and you're immunodeficient,

and we know that from animal models, we know it from people. We know a lot about, and you've had Dr. Hazen on the shows, studied this in the most robust scientific way possible. We know what a healthy microbiome kind of looks like, diverse and rich. We've yet to dial it into this organism, that organism. So, you know, we know that good diets that people that eat real food, you know, usually have a more diverse and rich microbiome and that supports immunologic health. I'm reluctant to tell people, you know, Carl Sagan used to say, you know, that extraordinary claims require extraordinary data. And so, you know, we don't know how to reduce it

to that crystallized, eat this, do this one thing. It's probably much more complicated than that, but we do know that prudent diets versus sad diets, a huge effect on the immune system. In the frame of functional medicine, we often people fall on elimination diets, which is eliminating inflammatory foods and anti-inflammatory diet. Things like gluten and dairy can be an issue. Processed food, obviously. Eating more whole foods, plant-rich foods is really key. So that's sort of what you're saying. Absolutely.

Yeah. All right, so next topic would be, you said exercise. Exercise. So I've been interested in exercise and immunity for decades, actually. Probably one of the first areas of behavior and immunity that I became interested in. And it's a complex area to talk. So over the past many years, I try to invite world leaders in all of these areas to my center to visit. And last year we had David Neiman, who's one of the undisputed leaders in this field.

And, you know, I do believe in what we call the J curve of exercise, that people who are sedentary, people who are sedentary are immunocompromised. And we know this both from the laboratory and the risks of, you know, the kind of the canary in the coal mine that we measure usually is respiratory illnesses. And how many is normal and how many do you get? But being a couch potato is bad for your immune system. It is definitely bad for your immune system as well as virtually every other system in your body.

But I'm looking from the lens of immunologic strength. And we just talked about heart disease and things like that, but this is a whole new view. This is it. The thing that you can do to demonstrate immunologic enhancement is moderate exercise. And, you know, walking is an incredible form of immunologic strength building. And we actively endorse and what we talk to about our patients is just like with the diet. Tell me where you're at in this spectrum of exercise.

Are you the couch potato and you work in a cubicle and you're sitting there all day long, you're doing nothing? Or are you training for ultra marathons at the other end? No matter where you are, we try to move people down a bit at a time. And Betsy and I, my nurse practitioner, world's best nurse practitioner, we talk to our patients about instant recess. That's what we call it. We say, you know, if you're totally sedentary, just get up and start moving. And now, I'm copying you, so in my immunologic summits for the past two years, I invite our head yoga teacher from the Cleveland Clinic, Judy, who comes and we do yoga at all the sessions. So the first time I did this at a scientific meeting, these guys are like, what?

What is going on here? And now it's like so popular. So anyway, we start moving the needle down to moderate exercise. There still is some data and there's some controversy that's recently been added into this. You know, the middle path is very strong for health and wellness. And, you know, you can, too much of something is often as bad as not doing it. And there have been a lot of epidemiologic evidence to show people who are ultra-exercisers

can actually do harm. Like marathon runners. And beyond, now we have people, ultra-marathon runners. I don't think it's coincidental, and I'm sure you've seen this in your practice. I've seen many people who have developed, you know, what we would recognize now as chronic fatigue syndrome, who had started out as very high endurance athletes, and then something has fallen apart. And you just wonder in your head of whether this was a predisposing factor, but we get people moving. So there was a very interesting study

done at the University of Colorado in the last about 18 months where they experimentally took a group of people who work at a sedentary job, cubicle, sit there all day long, and they randomized them to you get to go to a gym and come in a half hour late and you do 30 minutes on the treadmill versus you who all you have to do is for five hours during the day, get up and walk around

five minutes out of each hour, five minutes out of each hour. And then they measured a number of outputs. And while they didn't do immunologic function they looked at vitality well-being mood etc the people who won were the people who were just getting up and walking around yeah and you know you don't need a step counter the 10 000 steps all of that stuff that mike roizen talks about and our whole enterprise engages and. You know, I think it's good for your body, it's good for your brain, and it's clearly good for your immune system. So it's just a small bit of data. And similar to what we talked about

from the nurse's health study on diet, there have been several large epidemiologic studies to show that people who carry the predisposition to rheumatoid arthritis, who are more physically active, will have a lower incidence of actually developing the disease over a lifetime. So you've got two areas that there's clearly enough data for so many reasons, cardiovascular health, emotional wellbeing, and immunologic strength. So what happens to your immune system when you exercise? Not like the ultramarathoners. And I know you've written about this where you see

even clinical studies looking at ultramarathoners versus regular folks, their immune system is different, their oxidative stress is more. What is actually happening when you exercise your immune system? It's actually still relatively poorly understood. If you divide it into two types of studies, one are the studies where you can do it in a lab and come in and do an exhaustive stress test or cycle until you've hit the oxidation wall and hit your aerobic capacity. There, it's not surprising that all types of things happen to your immune system. You have trafficking of immunologic cells, you have elevations of inflammatory cytokines. Those are the mediators that cause inflammation and redistribution of lymphocytes like T cells

and B cells. I've always said, well, I would expect that. That's just stress and your immune system is moving to stress. The more important question is if you take a person who's sedentary and a person who has moderate activity and a person who is an ultramarathoner, do their immune systems differ by what we have traditionally measured? T-cells and B-cells and inflammatory cytokines and the like. And the answer is there's very little difference that we can detect. And my response to that is, is that, you know, we have very poor tools. We're just now, you know, we're looking with, we're looking with an eyeglass instead of a telescope. We're looking at the same techniques

that we looked at, you know, 40 years ago, where in the next five years, we'll be looking with, you know, what we recognize as omic technologies, where we're looking at the entire cloud of data of how your genes are functioning and how your your proteome and metabolome so some of that work is starting to be done right now and i i look forward to seeing more of it that's pretty exciting so eating right exercise let's talk about stress because i think the data is pretty clear that stress is not good for your immune system, but that the act of managing stress or actually doing things that help reset your stress response actually can help your immune system. And it's really the conversation about molecules of emotion. It really is. I think that

this is the most exciting area going on in immune behavioral science right now. And the data that are being generated are, you know, pretty impressive. So let's just talk about, let me back up and give you just a magic minute on triggering the immune system. So, you know, we have this immune system here. It's designed to defend us from all types of dangerous signals. We traditionally think of that as external signals such as, you know, infections, and it certainly does all that. There is another set of danger signals that we are just now starting to understand. And you brought up the term psychoneuroimmunology. Mouthful. It is, it is. And it's your psyche, your nervous system, and your immune system. And, you know, we don't know what stress levels were 200, 500, 5,000 years ago,

but we do know that today, living in this world, stresses are different. You know, you're carrying your phone in your pocket. I had to turn it off when I came in here, and I'm probably already getting nervous about how many emails are stacking up while I'm having this nice conversation with you. The, you know, the exigencies of modern life are complicated. Add to that the environmental stresses. You know, we're living in a world where, you know, the temperature is rising, pollutants are bombarding our body. Those are danger signals.

And so there is a tonic level of stress there that I think is probably new in the industrial age. Processing that is our brain, by and large. And the brain can send signals to the body that promote inflammation. You know, inflammation is good when you cut your finger. It's bad when you have it for 10 years. So the immune system is triggered by stress to generate accelerated inflammation,

which contributes to all these immune mediated inflammatory diseases that we're talking about. Yeah. Contributes to acceleration of aging. And that includes aging of the immune system. And we have this great term called immunosinnescence. You know, your immune system. Doesn't sound good. It does not sound good. Right. So, so all of this is going on. It's like dying of your immune system. It doesn't sound good. It does not sound good, right. So all of this is going on. It's like dying of your immune system is what it means in English. That's right.

So with that as a background, the question is, you know, what the heck do we do about it? Yeah. And I think the science is really good about what happens to your immune system under stress. It's not just an idea, oh, stress is bad for you. It's actually mapped out pretty well.

It's mapped out in incredible detail. And we can look at people who have mood disorders. We can look at people who are caregivers for patients with cancer or dementia. We can look at people with PTSD. We can look at all of these populations. And there's profound perturbation of their immune response. So how do we move that needle? How can we do that? Well, you know, there are a variety of techniques, but the ones that have been best studied surround the use of mindfulness meditation.

And I'd like to just take a couple of minutes to talk about this with you because I know that you're a great practitioner. And so for those in your audience who are many of are well familiar with this, the cognitively based mindfulness based stress reduction developed by Jon Kabat-Zinn 25, 30 years ago has been the standard bearer of research. And, you know, I give unbelievable credit to his pioneering efforts and all the data that's been generated for this. But as you know, this is pretty demanding stuff. And, you know, day of introduction, you know, you have coursework. Getting stressed is hard work. I always said if I had enough time for CBCT, I wouldn't be stressed. Mindfulness-based stress reduction.

I'm sorry, mindfulness-based stress reduction. So I've been asking the question for the past number of years, whether lower doses of mindfulness can have beneficial effects on all the domains that MBSR has had effects on. So in an hour, twice a day, maybe there's like a different dose. Maybe there's so, you know, we have a program that develops at the Cleveland Clinic, Stress-Free Now. And Stress-Free Now has been used in multiple settings, and we've published in scientific literature, you know, when, you know, hundreds of engineers have taken this, people from call-in centers that are all stressed out, that 15 minutes four times a week

appears to lower stress levels. 15 minutes twice a week. 15 minutes four times a week seems to be a sweet spot, which is, you know, that's doable. Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts. And follow me on all social media channels at DrMarkHyman.

And we'll see you next time on The Doctor's Pharmacy. Hey everybody, it's Dr. Hyman. Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things Thanks for tuning into The Doctor's Pharmacy. I hope you're loving this podcast. It's one of my favorite things to do and introduce to you all the experts that I know and I love and that I've learned so much from. And I want to tell you about something else I'm doing, which is called Mark's Picks. It's my weekly newsletter. And in it, I share my favorite stuff from foods to supplements to gadgets to tools to enhance your health.

It's all the cool stuff that I use and that my team uses to optimize and enhance our health. And I'd love you to sign up for the weekly newsletter. I'll only send it to you once a week on Fridays. Nothing else, I promise. And all you do is go to drhyman.com forward slash PICS to sign up. That's drhyman.com forward slash PICS, P-I-C-K-S, and sign up for the newsletter, and I'll share with you my favorite stuff that I use to enhance my health and get healthier and better and live younger longer. This podcast is separate from my clinical practice at the

Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. It's not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey,

seek out a qualified medical practitioner now. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner and can help you make changes, especially when it comes to your health. Keeping this podcast free is part of my mission to bring practical ways of improving health to the general public. And in keeping with that theme, I'd like to express gratitude to those sponsors that made today's podcast possible.